The diseases of infants and children . t. The nurse grasps the childselbows from outside of the blanket and holds them firmly, but should notpress them against the chest in such a way as to embarrass the respiratorymovements. At the same time the legs of the patient should be securedby l)eing held between the knees of tlie nurse. The head of the patientis held firmly between the open hands of the assistant, placed on eitherside of the head and cheeks. The left hand of the assistant may also beused to steady the mouth-gag after it has been introduced (Fig. 143). 468 THE DISEASES OF CHILDREN As
The diseases of infants and children . t. The nurse grasps the childselbows from outside of the blanket and holds them firmly, but should notpress them against the chest in such a way as to embarrass the respiratorymovements. At the same time the legs of the patient should be securedby l)eing held between the knees of tlie nurse. The head of the patientis held firmly between the open hands of the assistant, placed on eitherside of the head and cheeks. The left hand of the assistant may also beused to steady the mouth-gag after it has been introduced (Fig. 143). 468 THE DISEASES OF CHILDREN As before stated, the tube may be introduced with the child in the recum-bent^^posture. This I have done when, from the condition of the circu-lation, I did not think it advisable to lift the patient to the sitting mouth is opened and the blades of the mouth-gag introduced betweenthe molar teeth upon the left side, and the jaws opened by this as widelyas possible. The surgeon next passes the index-finger of the left hand into. Fig. 143.— Inserting the Tibe.(Wharton, Starrs Amer. Text-book of Diseases of Children, 1894, 314.) the pharynx and feels for the epiglottis, hooking this forward by the endof the finger. The tube attached to the introducer held in the right handis next passed into the mouth and carried back to the pharynx, the opera-tor being careful to see that it hugs the base of the tongue in the middleline, that the handle is depressed well upon the childs chest, and that thesilken loop is free. When the extremity of the tube comes in contact withthe end of the finger resting upon the epiglottis, the handle of the instru-ment should be raised as the tube enters into the larynx and descends into DIPHTHERIA 469 that organ, and when in position, the finger is placed upon the head of thetube to prevent its being withdrawn with the obturator. The trigger isnext pressed, and the introducer and obturator withdrawn from the mouthby depressing the hand
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